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54 záznamů v Medvik Filtry

Článek

Association of Baseline Hyperglycemia With Outcomes of Patients With and Without Diabetes With Acute Ischemic Stroke Treated With Intravenous Thrombolysis: A Propensity Score-Matched Analysis From the SITS-ISTR Registry

Tsivgoulis, Georgios
Autor Tsivgoulis, Georgios Second Department of Neurology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece tsivgoulisgiorg@yahoo.gr. Department of Neurology, University of Tennessee Health Science Center, Memphis, TN
Katsanos, Aristeidis H
Autor Katsanos, Aristeidis H Second Department of Neurology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece. Department of Neurology, St. Josef-Hospital, Ruhr University, Bochum, Germany
Mavridis, Dimitris
Autor Mavridis, Dimitris Department of Primary Education, University of Ioannina, Ioannina, Greece. Faculté de Médecine, Université Paris Descartes, Paris, France
Lambadiari, Vaia
Autor Lambadiari, Vaia Research Unit and Diabetes Center, Second Department of Internal Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
Roffe, Christine
Autor Roffe, Christine University Hospital of North Midlands, Stoke-on-Trent, U.K., and Keele University, Keele, U.K
Macleod, Mary Joan
Autor Macleod, Mary Joan Division of Applied Medicine, University of Aberdeen, Foresterhill, U.K
Sevcik, Petr
Autor Sevcik, Petr Department of Neurology, Faculty of Medicine in Pilsen, Charles University in Prague, Pilsen, Czech Republic
Cappellari, Manuel
Autor Cappellari, Manuel Stroke Unit, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
Nevšímalová, Miroslava
Autor Nevšímalová, Miroslava Department of Neurology, Hospital Ceske Budejovice, Statutory City, Czech Republic
Toni, Danilo
Autor Toni, Danilo Neurovascular Unit, Policlinico Umberto I, Department of Human Neurosciences, University of Rome, "La Sapienza," Rome, Italy

Diabetes. 2019 ; 68 (9) : 1861-1869. [pub] 20190619

ISSN 1939-327X
Medvik
Zdroj

Available data from observational studies on the association of admission hyperglycemia (aHG) with outcomes of patients with acute ischemic stroke (AIS) treated with intravenous thrombolysis (IVT) are contradictory, especially when stratified by diabetes mellitus (DM) history. We assessed the association of aHG (≥144 mg/dL) with outcomes stratified by DM history using propensity score-matched (PSM) data from the SITS-ISTR. The primary safety outcome was symptomatic intracranial hemorrhage (SICH); 3-month functional independence (FI) (modified Rankin Scale [mRS] scores 0-2) represented the primary efficacy outcome. Patients with and without aHG did not differ in baseline characteristics both in the non-DM (n = 12,318) and DM (n = 6,572) PSM subgroups. In the non-DM group, patients with aHG had lower 3-month FI rates (53.3% vs. 57.9%, P < 0.001), higher 3-month mortality rates (19.2% vs. 16.0%, P < 0.001), and similar symptomatic intracerebral hemorrhage (SICH) rates (1.7% vs. 1.8%, P = 0.563) compared with patients without aHG. Similarly, in the DM group, patients with aHG had lower rates of 3-month favorable functional outcome (mRS scores 0-1, 34.1% vs. 39.3%, P < 0.001) and FI (48.2% vs. 52.5%, P < 0.001), higher 3-month mortality rates (23.7% vs. 19.9%, P < 0.001), and similar SICH rates (2.2% vs. 2.7%, P = 0.224) compared with patients without aHG. In conclusion, aHG was associated with unfavorable 3-month clinical outcomes in patients with and without DM and AIS treated with IVT.

MeSH
cévní mozková příhoda krev komplikace farmakoterapie MeSH
diabetes mellitus krev MeSH
fibrinolytika terapeutické užití MeSH
hyperglykemie krev komplikace MeSH
ischemie mozku krev komplikace farmakoterapie MeSH
krevní glukóza MeSH
lidé středního věku MeSH
lidé MeSH
prognóza MeSH
registrace MeSH
senioři nad 80 let MeSH
senioři MeSH
tendenční skóre MeSH
tkáňový aktivátor plazminogenu terapeutické užití MeSH
trombolytická terapie MeSH
výsledek terapie MeSH
Check Tag
lidé středního věku MeSH
lidé MeSH
mužské pohlaví MeSH
senioři nad 80 let MeSH
senioři MeSH
ženské pohlaví MeSH
Publikační typ
časopisecké články MeSH
práce podpořená grantem MeSH

Článek

Diabetes mellitus u morčat – sporadické, nebo přehlížené onemocnění?
[Diabetes mellitus in guinea pigs - sporadic or marginalized disease?]

Hofmannová, Lada
Autor Autorita Ústav patologické morfologie a parazitologie, Brno

Veterinární lékař. 2018 ; 16 (3) : 135-140.

ISSN 1214-3774
Medvik
Zdroj

MeSH
diabetes mellitus * diagnóza dietoterapie farmakoterapie genetika krev veterinární MeSH
glykosurie moč veterinární MeSH
hyperglykemie krev veterinární MeSH
katarakta veterinární MeSH
morčata * MeSH
zvířata MeSH
Check Tag
morčata * MeSH
zvířata MeSH
Publikační typ
kazuistiky MeSH

Článek

Admission hyperglycemia and outcomes in large vessel occlusion strokes treated with mechanical thrombectomy

Journal of neurointerventional surgery. 2018 ; 10 (2) : 112-117. [pub] 20170313

J Neurointerv Surg
ISSN 1759-8486
Medvik
Zdroj

BACKGROUND AND PURPOSE: Higher admission serum glucose levels have been associated with poor outcomes in patients with acute ischemic stroke (AIS) treated with IV thrombolysis. We sought to evaluate the association of admission serum glucose with early outcomes of patients with emergent large vessel occlusion (ELVO) treated with mechanical thrombectomy (MT). METHODS: Consecutive AIS patients due to ELVO treated with MT in three tertiary stroke centers were evaluated. The following outcomes were documented using standard definitions: symptomatic intracranial hemorrhage (sICH), complete reperfusion, mortality, functional independence (modified Rankin Scale (mRS) score of 0-2), and functional improvement (shift in mRS score) at 3 months. The association of admission serum glucose and admission hyperglycemia (>140 mg/dL) with outcomes was evaluated using univariable and multivariable binary and ordinal logistic regression models. RESULTS: 231 AIS patients with ELVO (mean age 62±14 years, 51% men, median admission National Institute of Health Stroke Scale score 16 points (IQR 12-21), median admission serum glucose 125 mg/dL (IQR 104-162)) were treated with MT. Admission hyperglycemia was associated with a lower likelihood of functional improvement (common OR 0.53; 95% CI 0.31 to 0.97; p=0.027) and higher odds of 3 month mortality (OR 2.76; 95% CI 1.40 to 5.44; p=0.004) in multivariable analyses adjusting for potential confounders. A 10 mg/dL increase in admission blood glucose was associated with a higher likelihood of sICH (OR 1.07; 95% CI 1.01 to 1.13; p=0.033) and 3 month mortality (OR 1.07; 95% CI 1.02 to 1.12; p=0.004) in multivariable models. There was no association between admission serum glucose or hyperglycemia and complete reperfusion. CONCLUSIONS: Higher admission serum glucose and admission hyperglycemia are independent predictors of adverse outcomes in ELVO patients treated with MT.

MeSH
cévní mozková příhoda krev mortalita chirurgie MeSH
hyperglykemie krev mortalita chirurgie MeSH
ischemie mozku krev mortalita chirurgie MeSH
krevní glukóza metabolismus MeSH
lidé středního věku MeSH
lidé MeSH
příjem pacientů trendy MeSH
prospektivní studie MeSH
reperfuze škodlivé účinky trendy MeSH
retrospektivní studie MeSH
senioři MeSH
trombektomie škodlivé účinky trendy MeSH
výsledek terapie MeSH
Check Tag
lidé středního věku MeSH
lidé MeSH
mužské pohlaví MeSH
senioři MeSH
ženské pohlaví MeSH
Publikační typ
časopisecké články MeSH

Abstrakt

Diabetes mellitus 2. typu, obezita a nádorová onemocnění

Atherosklerosa .... 2017 ; () : 66-71.

ISBN 978-89-905595-4-7
Medvik
Zdroj

Článek

Hyperglycemia During Home Parenteral Nutrition Administration in Patients Without Diabetes

JPEN. Journal of parenteral and enteral nutrition. 2017 ; 41 (4) : 672-677. [pub] 20150921

JPEN J Parenter Enteral Nutr
ISSN 1941-2444
Medvik
Zdroj

BACKGROUND: Parenteral nutrition (PN) is a life-sustaining therapy in appropriate clinical settings. In the hospital setting, some nondiabetic patients develop hyperglycemia and subsequently require long-term insulin while receiving PN. Whether similar hyperglycemia is seen in the outpatient setting is unclear. METHODS: We studied patients enrolled in the Mayo Clinic Home Parenteral Nutrition (HPN) program between January 1, 2010, and December 31, 2012. Patients were excluded if they had diabetes mellitus type 2 (DM2), had previously received HPN, had taken corticosteroids, or were at risk for refeeding syndrome. RESULTS: Of 144 enrolled patients, 93 met inclusion criteria with 39 patients requiring the addition of insulin to HPN. The mean age of the insulin-requiring group (IR) was higher than that of the non-insulin-requiring group (NIR) (60.74 ± 13.62 years vs 48.97 ± 17.62 years, P < .001). There were 17 (44%) men in the IR group and 26 (48%) men in the NIR group. Mean blood glucose at baseline before starting the infusion was 131.82 ± 49.55 mg/dL in IR patients and 106.16 ± 59.01 mg/dL in NIR patients ( P = .03). In the stepwise multivariate analysis for assessing the risk for developing hyperglycemia, HR for age was 1.020 (1.010-1.031), P < .001. CONCLUSIONS: Hyperglycemia is a common finding with the use of PN in both the hospital and ambulatory setting in patients without a previous diagnosis of DM2. Age was the most significant predictor of the requirement of insulin in the present study. When hyperglycemia is managed appropriately with insulin therapy, the long-term complications can be minimized.

MeSH
diabetes mellitus 2. typu MeSH
dospělí MeSH
hormony kůry nadledvin terapeutické užití MeSH
hyperglykemie krev epidemiologie etiologie MeSH
inzulin terapeutické užití MeSH
krevní glukóza metabolismus MeSH
lidé středního věku MeSH
lidé MeSH
parenterální výživa doma škodlivé účinky MeSH
prevalence MeSH
proporcionální rizikové modely MeSH
retrospektivní studie MeSH
rizikové faktory MeSH
senioři MeSH
Check Tag
dospělí MeSH
lidé středního věku MeSH
lidé MeSH
mužské pohlaví MeSH
senioři MeSH
ženské pohlaví MeSH
Publikační typ
časopisecké články MeSH
Research Support, N.I.H., Extramural MeSH

Článek

Effect of continuous exenatide infusion on cardiac function and peri-operative glucose control in patients undergoing cardiac surgery: A single-blind, randomized controlled trial

Diabetes, obesity and metabolism. 2017 ; 19 (12) : 1818-1822. [pub] 20170731

Diabetes Obes Metab
ISSN 1463-1326
Medvik
Zdroj

We performed a randomized controlled trial with the glucagon-like peptide-1 (GLP-1) receptor agonist exenatide as add-on to standard peri-operative insulin therapy in patients undergoing elective cardiac surgery. The aims of the study were to intensify peri-operative glucose control while minimizing the risk of hypoglycaemia and to evaluate the suggested cardioprotective effects of GLP-1-based treatments. A total of 38 patients with decreased left ventricular systolic function (ejection fraction ≤50%) scheduled for elective coronary artery bypass grafting (CABG) were randomized to receive either exenatide or placebo in a continuous 72-hour intravenous (i.v.) infusion on top of standard peri-operative insulin therapy. While no significant difference in postoperative echocardiographic variables was found between the groups, participants receiving exenatide showed improved peri-operative glucose control as compared with the placebo group (average glycaemia 6.4 ± 0.5 vs 7.3 ± 0.8 mmol/L; P < .001; percentage of time in target range of 4.5-6.5 mmol/L 54.8% ± 14.5% vs 38.6% ± 14.4%; P = .001; percentage of time above target range 39.7% ± 13.9% vs 52.8% ± 15.2%; P = .009) without an increased risk of hypoglycaemia (glycaemia <3.3 mmol/L: 0.10 ± 0.32 vs 0.21 ± 0.42 episodes per participant; P = .586). Continuous administration of i.v. exenatide in patients undergoing elective CABG could provide a safe option for intensifying the peri-operative glucose management of such patients.

Kapitola

Poznámky k fyziologii a biochemii glukózy a inzulinu

Moderní diabetologie. 2017 ; () : 19-25.

ISBN 978-80-88129-19-6
Medvik
Zdroj

Kapitola

Patofyziologie metabolické poruchy při diabetes mellitus

Moderní diabetologie. 2017 ; () : 27-30.

ISBN 978-80-88129-19-6
Medvik
Zdroj

Článek

Experimental hyperglycemia induces an increase of monocyte and T-lymphocyte content in adipose tissue of healthy obese women

PLoS One. 2015 ; 10 (3) : e0122872. [pub] 20150420

ISSN 1932-6203
Medvik
Zdroj

BACKGROUND/OBJECTIVES: Hyperglycemia represents one of possible mediators for activation of immune system and may contribute to worsening of inflammatory state associated with obesity. The aim of our study was to investigate the effect of a short-term hyperglycemia (HG) on the phenotype and relative content of immune cells in circulation and subcutaneous abdominal adipose tissue (SAAT) in obese women without metabolic complications. SUBJECTS/METHODS: Three hour HG clamp with infusion of octreotide and control investigations with infusion of octreotide or saline were performed in three groups of obese women (Group1: HG, Group 2: Octreotide, Group 3: Saline, n=10 per group). Before and at the end of the interventions, samples of SAAT and blood were obtained. The relative content of immune cells in blood and SAAT was determined by flow cytometry. Gene expression analysis of immunity-related markers in SAAT was performed by quantitative real-time PCR. RESULTS: In blood, no changes in analysed immune cell population were observed in response to HG. In SAAT, HG induced an increase in the content of CD206 negative monocytes/macrophages (p<0.05) and T lymphocytes (both T helper and T cytotoxic lymphocytes, p<0.01). Further, HG promoted an increase of mRNA levels of immune response markers (CCL2, TLR4, TNFα) and lymphocyte markers (CD3g, CD4, CD8a, TBX21, GATA3, FoxP3) in SAAT (p<0.05 and 0.01). Under both control infusions, none of these changes were observed. CONCLUSIONS: Acute HG significantly increased the content of monocytes and lymphocytes in SAAT of healthy obese women. This result suggests that the short-term HG can modulate an immune status of AT in obese subjects.